| National Provider Identifier [NPI]: | 1033173380 |
| Last Name Of The Provider | GRAHAM |
| First Name Of The Provider | ANNETTE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5507 DORCHESTER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232253019 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 359 |
| Number Of Medicare Beneficiaries | 161 |
| Total Submitted Charge Amount | 39235 |
| Total Medicare Allowed Amount | 16376.15 |
| Total Medicare Payment Amount | 12918.43 |
| Total Medicare Standardized Payment Amount | 15077.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 59 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1675 |
| Total Drug Medicare AllowedAmount | 78.91 |
| Total Drug Medicare PaymentAmount | 61.85 |
| Total Drug Medicare Standardized Payment Amount | 61.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 300 |
| Number Of Medicare Beneficiaries With Medical Services | 161 |
| Total Medical Submitted Charge Amount | 37560 |
| Total Medical Medicare Allowed Amount | 16297.24 |
| Total Medical Medicare Payment Amount | 12856.58 |
| Total Medical Medicare Standardized Payment Amount | 15016.06 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 123 |
| Number Of Beneficiaries Age 65 to 74 | 26 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 98 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 69 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4612 |